Gender Differences In Periodontal Status And Oral Hygiene Of Systemically Healthy And Compromised Individuals
Blessy Pushparathna S1, Arvina Rajasekar2*
1 Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, Chennai- 77, India.
2 Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha University, Chennai- 77, India.
*Corresponding Author
Dr. Arvina Rajasekar,
Senior Lecturer, Department of Periodontics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences [SIMATS], Saveetha University, Chennai-
77, India.
Tel: +91 9486442309
E-mail: arvinar.sdc@saveetha.com
Received: September 13, 2021; Accepted: September 22, 2021; Published: September 23, 2021
Citation:Blessy Pushparathna S, Arvina Rajasekar. Gender Differences In Periodontal Status And Oral Hygiene Of Systemically Healthy And Compromised Individuals. Int J Dentistry Oral Sci. 2021;8(9):4597-4601. doi: dx.doi.org/10.19070/2377-8075-21000936
Copyright: Dr. Arvina Rajasekar©2021. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
Abstract
Introduction: Bacterial infections of the tissues that surround the teeth are more common which includes gingivitis and
periodontitis. Gingivitis may advance to periodontitis, a condition in which connective tissue attachment and alveolar bone
are destroyed, resulting in tooth loss.
Aim: This study aims to assess the gender differences in periodontal status and oral hygiene in systemically healthy and compromised
individuals.
Materials and Methods: The present study consisted of 200 outpatients who reported to the Department of Periodontics,
Saveetha Dental College and Hospitals, Chennai between December 2020 and January 2021 were enrolled. The patients were
categorised based on gender and systemic disease status. Then the oral hygiene index-Simplified (OHI), probing pocket depth
(PPD) and clinical attachment loss (CAL) were recorded. Chi-square test was done for data summarization and presentation.
The results were considered statistically significant when the p-value was <0.05.
Results: Among systemically compromised males, only 1.00% had good oral hygiene, 6.00% had fair and 17.00% had poor
oral hygiene. Also among systemically compromised females, 1.0%, 9% and 16.0% had good, fair and poor oral hygiene status.
Among systemically compromised males, 4.00% of them had PPD of 1-3mm, 14.00% had PPD of 4-6mm and the rest 6.00%
had >6mm. Among systemically compromised females, 9.0% of them had PPD of 1-3mm, 9% of them had PPD of 4-6mm
and 5.0% had PPD of >6mm. Among systemically compromised males, 9.00% had a CAL of 4-6mm and 15.00% had CAL
greater than 6mm. Among systemically compromised females, 3.0% had CAL of 1-3mm, 12.0% had CAL of 4-6mm and
13.0% had CAL greater than 6mm.
Conclusion: The present study suggests that males presented with poor oral hygiene status, greater probing pocket depth and
greater clinical attachment loss when compared to females. Also, when systemically compromised and systemically healthy
individuals were compared, systemically compromised patients showed poor oral hygiene status, greater probing pocket depth
and greater clinical attachment loss.
2.Introduction
3.Materials and Methods
3.Results
4.Discussion
5.Conclusion
5.References
Keywords
Periodontitis; Oral Hygiene; Periodontal Probing Depth; Innovative; Clinical Attachment Loss; Innovative Technique.
Introduction
Periodontitis is a complex polymicrobial inflammatory disease that
affects over 100 million people worldwide and is partly responsible
for tooth loss. Periodontitis is a condition in which connective
tissue attachment and alveolar bone are destroyed, resulting in
tooth loss. The most common symptoms of severe periodontitis
include loss of attachment, alveolar bone and teeth, extending
beyond the local level to produce systemic effects, increases local
and systemic inflammation[1-6]. Even though the primary aetiology
of the periodontal disease is bacterial plaque, the disease is
aggravated by various risk factors including age, systemic diseases,
gender, genetic factors, smoking, stress, hormones[7-18].
Gender-based heterogeneity in periodontal disease has been witnessed in the recent past with huge mounting evidence. Gender
has been associated with the diverse occurrence of periodontal
disease in population studies and generally, males are known to
suffer greater from gum disease than females of comparable age.
Males usually exhibit poorer oral hygiene compared to females.
However, when oral hygiene, socioeconomic status, age, is correlated
with gender, males are found to be associated with more severe
periodontal disease. Females are more hygiene and esthetics
conscious and seek dental treatment more often when compared
to males[18-21].
Numerous studies have revealed the association between periodontitis
and different systemic diseases such as cardiovascular disorders
like atherosclerosis [22], myocardial infarction and stroke
[23, 24], diabetes mellitus [25, 26], adverse pregnancy outcomes
[15, 27] and respiratory diseases [28, 29]. According to the concept
highlighted by Miller as focal infection theory, the periodontal
infection may act as a focus of infection for systemic diseases
[30, 31]. In periodontitis, due to the virulence nature of periodontal
pathogens, the epithelial barrier is breached and thus the
bacterial endotoxin enters into the underlying connective tissues
and blood vessels, thereby entering the systemic blood circulation.
This is considered to be the primary mechanism of periodontitisrelated
systemic diseases.
Our team has extensive knowledge and research experience that
has translated into high-quality publications [32-51]. Literature
search reveals studies assessing gender differences in oral hygiene
and periodontal status of systemically healthy and compromised
individuals were minimal. In this context, the present study was
undertaken to assess the gender differences in periodontal status
and oral hygiene in systemically healthy and compromised individuals.
Materials and Methods
This cross-sectional study was conducted in the Department of
Periodontics, Saveetha Dental College and Hospitals, Chennai. A
total of 200 patients who reported between December 2020 and
January 2021 were enrolled. The patients were categorised based
on gender and systemic disease status. Then the oral hygiene index-
Simplified (OHI), probing pocket depth (PPD) and clinical
attachment loss (CAL) were recorded. The ethical clearance was
obtained from the Institutional Ethical Committee and written
informed consent was obtained from all the study participants.
The data was analyzed using Statistical Package for Social Sciences
(SPSS Software, Version 23.0). Chi-square test was done for data
summarization and presentation. The results were considered statistically
significant when the p-value was <0.05.
Results
A total of 200 patients were recruited in the study. Among the 200
patients, 96 were males and 104 were females. These 200 patients
were further divided based on their systemic status into 4 groups,
of which 24% males were systemically healthy, 26% females were
systemically healthy, 24% were systemically compromised males
and 26% were systemically compromised females.
Among systemically healthy males, 11.0% had OHI-S score of
0.0-0.6 (good), 6% had OHI-S score range of 0.7-1.8 (fair) and
7.0% had an OHI-S score of 1.9-3.0 (poor). Among healthy females,
13.0% had good oral hygiene, 11.0% had fair oral hygiene
and 2.0% had poor oral hygiene. Among systemically compromised
males, only 1.00% had good oral hygiene, 6.00% had fair
and 17.00% had poor oral hygiene. Also among systemically compromised
females, 1.0%, 9% and 16.0% had good, fair and poor
oral hygiene status respectively. The association between oral hygiene
index (OHI-S), gender and systemic health status was found
to be statistically significant (p<0.05). (Figure 1).
Among systemically healthy males, 9.0% had PPD of 1-3mm,
9.0% had PPD of 4-6mm and 6.0% had PPD greater than 6mm.
Among systemically healthy females, 13.0% of them had PPD
of 1-3mm, 10.0% had 4-6mm and 3.0% had greater than 6mm.
Among systemically compromised males, 4.00% of them had
PPD of 1-3mm, 14.00% had PPD of 4-6mm and the rest 6.00%
had >6mm. Among systemically compromised females, 9.0%
of them had PPD of 1-3mm, 9% of them had PPD of 4-6mm
and 5.0% had PPD of >6mm. The association between probing
pocket depth (PPD), gender and systemic health status was found
to be statistically significant (p<0.05). (Figure 2).
Among systemically healthy males, 7.0% of them had CAL of
1-3mm, 10.0% of them had CAL of 4-6mm and 7.0% had CAL
greater than 6mm. Among systemically healthy females, 13.0%
had CAL of 1-3mm, 10.0% had CAL of 4-6mm and 3.0% had
CAL greater than 6mm. Among systemically compromised males,
9.00% had a CAL of 4-6mm and 15.00% had CAL greater than
6mm. Among systemically compromised females, 3.0% had CAL
of 1-3mm, 12.0% had CAL of 4-6mm and 13.0% had CAL greater than 6mm. The association between clinical attachment loss
(CAL), gender and systemic health status were found to be statistically
significant (p<0.05). (Figure 3).
Figure 1. Graph depicts the correlation between oral hygiene index (OHI), gender and systemic health status. The X-axis represents the gender of the subjects and the Y-axis represents the OHI-S of the subjects. In the graph, purple represents OHI-S of 0.0-0.6mm, green represents OHI-S of 0.7-1.8mm and red represents OHI-S of 1.9-3mm. Majority of the systemically compromised males (17%) had poor oral hygiene (OHI-S of 1.9-3mm). The association between oral hygiene index (OHI-S), gender and systemic health status was found to be statistically significant (p<0.05) (Chi-square test).
Figure 2. Correlation graph between probing pocket depth (PPD), gender and systemic health status. The X-axis represents the gender of the subjects and the Y-axis represents the PPD of the subjects. In the above graph, purple represents PPD of 1-3mm, green represents PPD of 4-6mm and red represents PPD greater than 6mm. Majority of the systemically compromised males (6%) had greater PPD. The association PPD, gender and systemic health status was found to be statistically significant (p<0.05) (Chi-square test).
Figure 3: Correlation graph between clinical attachment loss (CAL), gender and systemic health status. The X-axis represents the gender of the subjects and the Y-axis represents the CAL of the subjects. In the graph, purple represents CAL of 1-3mm, green represents CAL of 4-6mm and red represents CAL greater than 6mm. Majority of systemically compromised males (15%) had greater CAL. The association between clinical attachment level (CAL), gender and systemic health status was found to be statistically significant (p<0.05).(Chi-square test).
Discussion
The present study was done to assess the gender differences in
periodontal status and oral hygiene status among systemically
healthy and systemically compromised individuals.
In the present study, it was observed that males had poor oral hygiene,
greater PPD and CAL when compared to females. Fukai K
et al., [52]conducted a study among 207 males and 196 females belonging
to the age group of 20-64 years and found that males had
poorer brushing habits than females. Use of mouthwash, flossing
and better dental hygiene behaviours likely explain the better oral
hygiene in women The percentage visiting the dental clinic for
regular examination was higher in females than in males. Examining
the relationship between oral hygiene status and oral health
habits it was found that men had poor oral hygiene than women.
Al Ansari et al., [53] conducted a cross-sectional study among 700
students, of which 153 were males and 547 were females. It was
reported that oral health was good among female students when
compared to males. Shiau HJ et al., [54] conducted a systematic
review to estimate the sex-related differences in the prevalence
of periodontitis and reported that men appear at greater risk for
periodontal disease than women. Shah P et al., [9] in the retrospective
study showed that the prevalence of periodontitis was higher
in males when compared to females. The results of the present
study are in agreement with the previous studies.
Also in the present study, it was observed that systemically compromised
individuals had poor oral hygiene status, greater PPD
and CAL as compared to systemically healthy individuals. Antina
Schulze et al., [55] investigated the relationship between gender
differences in periodontal status and oral hygiene status in Non-
Diabetic and Type 2 Diabetic patients. This study was conducted
among 171 non-diabetic, 205 type 2 diabetic patients. This study
concluded that oral hygiene behaviour was poor in males and also
periodontitis was more severe in males than in females. It also
showed that diabetic individuals showed a greater risk of periodontal
diseases compared to non-diabetic individuals.
Nikhil Sharma et al., [56] studied the association between respiratory
disease and periodontitis. A group of 100 hospitalized patients
with respiratory disease and a group of systemically healthy
patients from the outpatient clinic were checked for their OHI,
gingival inflammation, pocket depths, and CAL. The results indicated
that patients with respiratory disease had significantly poor
periodontal health. Karthikeyan et al., [1]conducted a study among
patients with chronic periodontitis and found that tooth loss was
more frequent in males as compared to females. Thanish AS et
al., [3] stated that the prevalence of tooth loss was high among
chronic periodontitis patients with diabetes compared to patients
without diabetes.
Kandhan T et al., [8] conducted a study among 1000 patients
(n=500 patients without systemic diseases and n=500: patients
with systemic diseases) and observed that systemically compromised
patients were more prone to periodontitis than systemically
healthy patients. Rajeshwaran N et al., [5] assessed the distribution of angular defects in chronic periodontitis patients with and
without systemic diseases and reported a higher prevalence of angular
bone defects in chronic periodontitis patients with systemic
diseases. Shukri N et al., [12] in the retrospective study showed a
greater prevalence of gingivitis and periodontitis among diabetic
patients. The results of the present study are in accordance with
the previous studies as the systemically compromised patients
showed greater PPD and CAL when compared with systemically
healthy individuals.
Conclusion
The present study suggests that males presented with poor oral
hygiene status, greater probing pocket depth and greater clinical
attachment loss when compared to females. Also, when systemically
compromised and systemically healthy individuals were
compared, systemically compromised patients showed poor oral
hygiene status, greater probing pocket depth and greater clinical
attachment loss.
Acknowledgement
The authors would like to acknowledge the help and support rendered
by the Department of Periodontics, Saveetha Dental College
and Hospitals, Saveetha Institute of Medical and Technical
Sciences, Saveetha University, Chennai.
Source of Funding
The present project was sponsored by
• Saveetha Institute of Medical and Technical Sciences,
• Saveetha Dental College and Hospitals,
• Saveetha University,
• Raja Super Market, Chennai.
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